Effects of semi-immersive virtual reality and manipulation of optic flow speed on gait biomechanics in people post-stroke.
Emma De Keersmaecker, Anke Van Bladel, Silvia Zaccardi and 5 others
PMID 39601468WHAT IT FOUND
Adding semi-immersive virtual reality to self-paced treadmill walking did not change gait mechanics in people post-stroke, but it was safe and increased enjoyment.
Manipulating optic flow speed caused only small, likely clinically irrelevant changes in walking speed.
Key findings
01Adding semi-immersive VR did not significantly alter spatiotemporal gait parameters or lower limb kinematics in either group.
02People post-stroke reported significantly higher simulator sickness scores and greater enjoyment when walking with VR compared to without.
03Manipulating optic flow speed caused small changes in walking speed and cadence that did not reach the minimal clinically important difference.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only high-functioning ambulatory patients (FAC 2-4), so results may not apply to those with more severe gait impairments. The virtual environment was simple (a static city street with no game elements), which may explain the lack of gait changes compared to more complex VR tasks. The sample size was small (16 per group), and the kinematic analysis excluded some participants due to missing marker data, reducing statistical power. Simulator sickness increased significantly in the stroke group, although absolute scores remained low.
Declared interests
Emma De Keersmaecker is a Strategic Basic Research fellow funded by the Research Foundation – Flanders (FWO).
The easy way to misread this
Do not assume that manipulating optic flow speed is an effective tool for immediately changing gait speed in clinical practice. The observed changes were statistically significant but clinically irrelevant (less than the 0.10 m/s minimal clinically important difference), and the semi-immersive setup may not provide enough presence to drive strong motor adaptations.